Madalynn Dianne Bruckner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003979A Issued in IN

Practice address

506 Wabash Avenue
Terre Haute, IN 47807-3525

Phone

(812) 232-0073

Fax

(812) 232-0074

NPI assigned

Jun 30, 2016

Last updated

May 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Indiana LLCGroup PAC ID 5496091316, 82 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of Indiana, LLC

  dba MyEyeDr.

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Indiana, LLC

  dba MyEyeDr.

  • Optometrist
  • Terre Haute, IN
  • NPI 1588150908
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Munster, IN
  • NPI 1922974526
  NPD
• Eyecare Express-Terre Haute Inc.

  • Optometrist
  • Terre Haute, IN
  • NPI 1932308772
  NPD (past)
• Eyemart Express LLC

  dba Eyemart Express

  • Eyewear Supplier
  • Terre Haute, IN
  • NPI 1851140735
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1356792352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 WABASH AVENUE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478073525",
            "telephone_number": "812-232-0073",
            "fax_number": "812-232-0074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3347 S US Highway 41",
            "address_purpose": "LOCATION",
            "city": "Terre Haute",
            "state": "IN",
            "postal_code": "478023727",
            "country_code": "US",
            "telephone_number": "812-234-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "MADALYNN",
        "middle_name": "DIANNE",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003979A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Brown, D.C.
• Nicole Brown
• Raegan Brown
• Robert Leroy Brown, MSW, LCSW
• Jody Brent Brucker, ATC
• Travis J Brummer
• Kendall Bruner, DPT
• Dina Lynn Bryan, MEDICAL ASSISTANT
• Adam Buck, PMHNP
• Kimberly Buckingham

• Optometrist in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.